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BDEM2014-0001 (BDEM) �: ' �;�� IIIliiIIIIIIIIIIVIIIIIII 71 ` IE G�i 78-495 CALLE TAMPICO D VOICE(760)777-7125 FAX(760)777-7011 LA QUINTA,CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS(760)777-7153 BUILDING PERMIT Date: 10/1/2014 Application Number: BDEM2014-0001 Owner: Property Address: 81891 AVENUE 58 QUINTA DEL SOL LLC. APN: 764180003 6541 HOLLYWOOD BLVD.SUIT �)3 (:--D Application Description: DEMO SFD LOS ANGELES,CA 90028 z Property Zoning: c, O Application Valuation: $15,000.00 C__ �D s- Applicant: Contractor: QUINTA DEL SOL LLC. QUINTA DEL SOL LLC. o o C= 6541 HOLLYWOOD BLVD.SUITE 203 6541 HOLLYWOOD BLVD.SUI 19 LOS ANGELES,CA 90028 LOS ANGELES,CA 90028 z -1 (818)266-8414 Llc.No.::CONV:140528101253005727 --------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations: 9(commencing with Section 7000)of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self-insure for workers' and my License is in full force and effect. compensation,as provided for by Section 3700 of the Labor Code,for the performance 'License Class:_ License No.::CONV:140528101253005727 of the work for which this permit is issued. I have and will maintain workers'compensation insurance,as required by Date: Contractor: Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation insurance carrier and policy number are: OWNER-BUILDER DECLARATION Carrier:_ Policy Number:_ I hereby affirm under penalty of perjury that I am exempt from the Contractor's State G IJ •I certify that in the performance of the work for which this permit is issued,I License Law for the following reason(Sec.7031.5,Business and Professions Code:Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct,alter,improve,demolish,or repair compensation laws of California,and agree that,if I sh uld become subject to the any structure,prior to its issuance,also requires the applicant for the permit to file a workers'compensation provisions of Section 370 of th L'bor Code,I shall forthwith signed statement that he or she is licensed pursuant to the provisions of the comply with those provisions. 1 Contractor's State License Law(Chapter 9(commencing.with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the Date: `�/ I I Applicant: basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars WARNING:FAILURE TO SECURE WORKERS'COMPEN TI COVERAGE IS UNLAWFUL, ('/$50'10).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL.PI NALTIt AND CIVIL FINES UP TO 1,as owner of the property,or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS($100,000). IN ADDITION TO THE COST OF compensation,will do the work,and the structure is not intended or offered for sale. COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec.7044,Business and Professions Code:The Contractors'State License Law does not INTEREST,AND ATTORNEY'S FEES. apply to an owner of property who builds or improves thereon,and who does the work himself or herself through his or her own employees,provided that the improvements APPLICANT ACKNOWLEDGEMENT are not intended or offered for sale. If,however,the building or improvement is sold IMPORTANT:Application is hereby made to the Building Official for a permit subject to within one year of completion,the owner-builder will have the burden of proving that the conditions and restrictions set forth on this application. he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made,each person at whose (o )I,as owner of the property,am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit to construct the project. (Sec.7044,Business and Professions Code:The Contractors' issued as a result of this application,the owner,and the applicant, each agrees to,and State License Law does not apply to an owner of property who builds or improves shall defend,indemnify and hold harmless the City of La Quinta,its officers,agents,and thereon,and who contracts for the projects with a contractor(s)licensed pursuant to employees for any act or omission related to the work being performed under or the Contractors'State License Law.). following issuance of this permit. I am exempt under Sec. B.&P.C.for is reason 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit,or cessation of work for 180 days will subject permit to cancellation. Date: (0/1 /14 Owner . I certioy that I have read this application and state that the above information is correct. CONSTRUCTION LENDI A ENCY I agree to comply with all city and county ordinances and state laws r lacing to building I hereby affirm under penalty of perjury that there is a construction lending agency for construction,and hereby authorize representatives of this city to ente upon the above- the performance of the work for which this permit is issued(Sec.3097,Civ.C.). mentioned property for inspection purposes. I Lender's Name: Date: ( ) Signature(Applicant or Agent): Lender's Address: FINANCIAL INFORMATION DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE DEMOLITION,FULL 101-0000-42404 0 $24.31 $0.00 PAID BY METHOD RECEIPT# CHECK,# CLTD BY DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE DEMOLITION,FULL PC 101-0000-42600 0 $85.80 $0.00 PAID BY ' METHOD RECEIPT# CHECK# CLTD BY Total Paid for DEMOLITION: $110.11 $0.00 •TALS: $110.11 $0.00 a �'•G. ^ o� G V S Permit Details PERMIT NUMBER • 1 � � � . . o� s Description:DEMO SFD r78 Type:DEMOLITION Subtype:SINGLE FAMILY Status:APPROVED Applied:7/15/2014 SKH Parcel No:764180003 Site Address:81891 AVENUE 58 THERMAL,CA 92274 Approved:10/1/2014 SKH Subdivision: Block: Lot: Issued: Lot Sq Ft:0 Building Sq Ft:0 Zoning: Finaled: „s Valuation:$15,000.00 Occupancy Type: Construction Type: Expired: 7 No. Buildings:0 No.Stories:0 No. Unites:0 {, Details: DEMO-COMEPLETE DEMO OF(1)STRUCTURE.2013 CALIFORNIA BUILDING CODES. J Applied to Approved ADDITIONAL CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT QUINTA DEL SOL LLC. 6541 HOLLYWOOD LOS ANGELES CA 90028 (818)266-8414 BLVD.SUITE 203 CONTRACTOR QUINTA DEL SOL LLC. 6541 HOLLYWOOD LOS ANGELES CA 90028 (818)266-8414 BLVD.SUITE 203 OWNER QUINTA DEL SOL LLC. 6541 HOLLYWOOD LOS ANGELES CA 90028 (818)266-8414 BLVD.SUITE 203 FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT# CHECK# METHOD PAID BY CLTD BY DEMOLITION,FULL 101-0000-42404 0 $24.31 $0.00 Printed:Wednesday,October 01,2014 12:52:43 PM 1 of 2 gR SYSTEMS p� Qi•� o� o DetailsPermit PERMIT B • c s �'OF Tom' •` DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID GATE RECEIPT# CHECK# METHOD PAID BY CLTD BY� DEMOLITION,FULL PC 101-0000-42600 0 $85.80 $0.00 Total Paid for DEMOLITION: $110.11 $0.00 TOTALS: • • •• INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE PRE-SITE FINAL" PARENT PROJECTS REVIEWS RETURNED STATUS REMARKS REVIEW TYPE, REVIEWER SENT DATE DUE DATE DATE NOTES r.: NON-STRUCTURAL BUILDING 7/15/2014 7/22/2014 BUCKET PUBLIC WORKS AMY YU 8/1/2014 8/8/2014 8/6/2014 REVISIONS REQUIRED GREEN SHEET COMPLETED AND ROUTED TO AMY AS REQUESTED IN PREVIOUS CHECK.(SK) PUBLIC WORKS AMY YU 9/12/2014 . 9/19/2014 9/15/2014 APPROVED SIGNED OFF ON GREEN SHEET FOR DEMO ONLY, LESS THAN 1 ACRE BOND INFORMATION ATTACHMENTS Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED DOC 9/23/2014 STEPHANIE KHATAMI PM10 PERMIT PM10 PERMIT 0 BDEM2014-0001.pdf BDEM2014-0001.pdf Printed:Wednesday,October 01,2014 12:52:43 PM 2 of 2 V?w ySTEMS 1 , v x - x 436.9 AVf.56 ---------- ---------- - n a 7 437.6 --- ---- a 39.7 a. x 437.5 437.1 x t�7.8 437.3 7.3 t F- DI 437.3 436.5 PIU x 4 7.1 x x • 437.5436.8 �l x C/�r� C��,� x 38. i SCATTERED BRUSH CL 437.3 Q x 437.3 37.2 436.4 36.7 x 37.5 ui x 437.1 ' 436.5 LL 5.8 436.5*' (/` '<0 37. LL qJ 436.8 43 .a (j�vL 437.4 x o"J W 436 x 7.5 001- 436.2 Q itnbc O 436 432..1._ x x 437.1 x O F 4 x 8 O 0 0 0 W C � 43 . TAO 436.4 S ATTERED fkY1SH 436.7 CC N x 437.2 a3B 4 2 5. a 7.4 (`J?V1 x 435.8 436. x x 43 .7 43 8 435.9 ' 436.1 7 436.1 x {� 435x5 7 6.5 N 436.2 - -435.9 x ,.2 x +i /Y 5.9 x x 34. 10 435.6 436.1 V" (� t � x 435. C\� 1 5.6 x P#3 435.9 4 .87 x ? 435.5 x 3 435.8 cr 435.5 x .9 x 35 1 DIRT d SCATTERED BRUSHco � I J S.a 435.5 435.4 x 435.6 , II PI x --� 436.1 x 435.5 x OiR P 43 . 435.3 x 3x x435.3 x 434.6 434.7 x .435. �' N08�9 57Y14'W 324 BUILDING & SAFETY DEPARTMENT 78-495 CALLE TAMPICo (760) 777-7012 f Op T1 , LA QUtNTA, CALIFORNIA 92253 FAX (760) 777-70il PROPERTY OWNER'S PACKAGE Disclosures & Forms for Owner-Builders Applying for Construction Permits M-108TANT! NOTICE TO PIl OPEtiTY OWNER Dear Property Owner An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at We are providing you with an Owner-Builder Acknowledgnmt,and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not Issue a building,permit until.yon Have read,inidakesd your understanding of pack provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute dila,notice unless you,the property owner,obtain the prior approval of the permitting authority. �wIt�s�cxrlawr::�n�i�r aivi>r•vE1�cA�r�ON o>�n�o .��rl flfREC77OAM ,Read a uk inidal,. acir'.s&teme k blow ia.signi,pyyou iindersfand or.*Afy this information. OD 1. 1.tuiderstand a frequent practice of unlicensed persons is'to have the property owner .obtain an "Owner-Builder" building Perini(that erroneously implies that the property owner is providing his or her own Iabor:and maternal.personally.I,as. an Owner-Builder,may lie held liable and subject to serious financial risk for any injuries:sustained by an unlicet�sod pmmw and his or her employees while working on my property_ My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance-coverage for injuries to workers on my property_ Q2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. C>D!_3. I understand as an"Owner-Builder"I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. O k>4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 5.1 understand if I employ or otherwise engage any persons,other than California licensed Contractors,and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an"employer" under state and federal law. 6-I understand if I am considered an ,employee, under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. CL�N > 7. 1 understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. tj)_81* 1.and os�tand as a» Owner-Builder if I sell the property for which this permit is issued, I may be'bO-d liable..for any financial or. '(s'nal;:.irt cries zusbiiied by any subsequent owner(s) that result from any talent construction defects in the Workr6aaslup or ruatdniis. 29. 1 understand I may obtain more information'regaTilihg.m Y oblikalimis*is an­emt)Wy&-4 hv'm thk; tntc=I CaliforniaLzvcnue Service,the United States Small Business Administration,thc�Califbrnia Department of Benefit Payments,and the Cf Division of Industrial Accidents.I also understand Imay.contact dueCalifornia.Contractors'State UcCMC'B0ar5l(CSL13 I. .)all- 800-321-CSLB(2752)or www.cslb-,ca.gov for more information about licensed contractors. -0 1) 10.1 am aware of and consent to an Owner-Builder building permit applied for in my name,and understand that I am the party legally and financially responsible for proposed -construction activity at the following address: 8 ( �(�, k - At-je..1gp_ _�e, - L_A- 1, NVC-A,V _C_A ' . 9 ®i>I L I agree that,as the party legally and financially responsible for this proposed construction aWvitY.I will abide by all applicable lawsand.requirements,that govern Owner-Buil&fs as well as c * loyem . Mp 12.1 agree to oo'tify the issuer of this form immediately of any additions;deletions,or changes to any Of the iG1ofn3&fiQh I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If YOU e`0fftMct with someone who does not have a tim=,tore contractors' State License Board may be unable to assist you with any finaticial Ion you may sustain as a result of a complaint Your only remedy against unlicensed Contractors may be in,6vil court It is also u"Pwmt for You to understand that if an unlicensed Contractor or employee of that individual or firm is injured wtdk vioddrig on your property;you maybe hdd.liable:for dWn*cs.-If you obtain a permit as Owocr-Builderlaoel Wid,to him conuft4ors, you will be reVousible forv vvbedta<or not those contractors weproperty. lkbasM-and ft status oftlicir WotkeW compensation instuaam coverage. Before a buflding permit can be issued,this form st be co Y:ptet ainpigned by the property owner and returned to f Wm"kdo"bM or ,gkc.p� prop the agency responsible for �Cvp 7ty owner's driver's Acensei f other ver�rlcafion acceptable so the ager Is req ed to be pres Wh the permit is issued to Va* the FVP" owner's signature. 1�7 _T I(,..I I 1A Signature of property owner 9�1� Date: I_ -C Note'- The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder. AU ICHORIZATION OFAGENTTO ACT ON rR01PF_RT-k OWNER'S WHALF Excluding the Notice to Property Owner,the execution of which I undentandds my personal responsibility,I hereby authorize ,the following pemn(s)to act as my agents)gent(s)to apply for,sign,and file the docu,meuts,necessary to obtain an Ownec-Buildtr Permit for my project. Scope of Construction Project(or Description of Work): e-,to Project Location or Address: .'g � �qj A_4eue L4 CA Name of Authorized Agent: G J, OHO \h 4-A, Q Tel No IR14LLA�Co Address of Authorized Agent: CjQV, AA)C q–to u N C)I CA 3 under-penalty-of-pedufy-th-at-l-am-the property owner-for the-address listed-above and-l-PersODMIY lilled-out the above—— information and certify its accuracy.Note.-A copy of the owner's drivers license,form notarization,or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: Ly I: =Builder if I sell the property for w�bich this permit is issued, I may be held liable,for any Iirianeial br pcfsonal;iccuiies: istiaiiicd:by any subsequent owner(s) that result from any latent constntction defects in the wQrlamanslup 6i'ma'.teraals.. 0 9. I iurdentand I may obtain more information' [c'g'ardin"g.my'bbl'igatioris:es ui►":etiijiloycr" fro, tlii Yn)cr>xat ke'!Cnue Service,the United States Small Business Administretioc►;.t1ic Califonua Dcp rtrncnt of lldO07rt raymenls,and clic CalrCoruia Division of Industrial Accidents.I also understand I:may:contact:the California Contraetbts'State.iieenscT3oard(CL.I )at.l- f 800-321-CSLB(2752)or www.cslb:ca.gov for more information about licensed contractors. 10.I am aware of and consent to an Owner-Builder building permit applied for in my name,and understand that I am the party legally and financially responsible :for proposed construction activity at the following address: 11. I agorae that,as the party legally and hummially responsible for,this proposed construction activity,I will abide'by all applicable laws and.requirements-that-govern.Owner_Buildera-as_well-as employvers..----------..—_------.-------._.__—.----------------- . 12.I agree to notify the issuer of this form immediately of any additions;dektk=,or'changes to any-Of the wfotmalkit I have provided on this form Licensed"contractors are regulated by laws designed to.protect the public. If you Contract with someone who does not have a license; ten the Goattac6ors'State Ucense Board.rMy be Mable to assist jiou with 84y'finan6al loss you may sustain as a result of a complaint Your only iemcdy: gainst unlicensed Contractors:may be 1n'6vil court.It is also important for you tounderstand thit.if an unlicensed Contractororetaployce of that individual or firm is injuirod while worlang on your property;you maybe lYcld:.lialilc:fox.datiiagcs :If.you.oblain a pcinxU�s�Ow =l3wldet and wx':to;hire Contractors, you will be sesponsrlrlc for.v wliEximar or clot tltose`,CoiittzicCors arc lics canscd'aricl'tlre tXi..of ditir wotkces' cu tfytn� ProPc�riY compensation ir>Suranoe coverage. Before a building permit can be issued,this form st be completed an signed by the property owner and returned to the agency respousible for iss :tfic:pFtrm#: oma A copy of ticc'pro owner's dkiver''r_Joerrsey wen notat�prepim or other verification aecepkzble to.the agen ss req 'ed to be fres ' w+k dir permit,is•iasued to Verify tke prop'" owner's signature. Signature of property owner., AM1111" Date:_2L I L Q Note_ The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder. AUTHORIZATION OF'AGENTTO ACT ON PROPERTY OWNEWS..BEHALF Excluding the Notice to Property Owner,the execution of which I understand•is my ,personal responsibility,I hereby authorize -the following persons)to act' s my agents)to apply for,sign,and file the documents necessary to obtain an Owner-Builder Permit for my project. i Scope of Construction Project(or Description of Work):. Wit"t Ol �-t ►,� Project Location or Address; Q, 8"Q 1 A,3e FJUe- CA ' Name of eAuthorized Agent: J, OHO V Tel No. l t-100-(0 23 Address of Authorized Agent: (�q V A4C_ q_oe_�N O <�:A 3 � i --- • -I-declare-underpenalty-of perjury-tliat-1 am-the property owner for-thc-address-listed-above-and-I-pers nMIY-filled-out-the-above --- information and certify its accuracy.Note_A copy of the owner's driver's license,form notarization,or,other verification acceptable to the agency is required to be presented when the permit is issued io verify the property owner's signature. Property Owner's Signature:. Date: "� `t k WC O E O 00 U N O O N O � as by � CALlJF0 � ;' DRIVE � DL72. ' 852783' � tAss C EXp '0 1271201 `' END NONE LN DAYAN FN LIFER PO BX 260394 ENCINO, CA 91426 �B ,08/27i1970 �- NONE t SEX -M HAIR BLK EYES 13W , r.MGr F-W" WGT 178 4b DD 07/23/2008515R8/DDFp/18,• `07110/2013 ECEIVED a K . JUL 3 2014 CITY OF LA QUINTA COMMUNITY DEVELOPMENT ' 0 ��rALIFOR�liliil � ORIV LIC - k%/1. llt1/ -�64i-.�'2-.sl- •��- rrr-`� � � /l � -�_Y\ . o -68T L ir�11r ,TTAEE- �s� r� °1 5460 WHITE OAK AVE AP_-T-=C102— _ - ENUNO�CA^to 6 ` �o 161.09 1:91 - ` ! _ • t- - - -�-.. � ., �SEX�M =HA.--L'K�YES BRN - ����' !�— RE .aS � `0$/20/261466326I60FDN6 0 30J2014— t j SCOTT . RRISOIN & ASSOCIATES P 0. Box 55320 31855 Date Palm 13rive,Ste.#3-507 Riverside,C A 92517 Cathedral City,CA,922234 (%4)624-1665 (76(3)323-7743 ............ ............ ASBESTOS SURVEY REPORT Completed On June 26, 2006 P"1062341161 Client: Quinta Dal Sol, LLC 6541 Hollywood Blvd.,#203 L.A.,CA 90028 Project.- 81891 Ave, 58 La Quinta, CA (single-family home with attached garage) On June 23, 2006 an asbestos inspektion and bulk sampling was conducted at the above project address. Bulk samples were taken of all suspect asbestos containing building materials (A CBM).at the request of the client named above. Bulk.samples were submitted to Carolina Environmental, Inc. located at: 107 New Edition Court in Cary, NC:-(NVLAP Code 101,768-0 and Cal. Environ. Lab. Cert. #2483) to estimate the percentage of'asbestos by"volume and determine the type(s)present . Carolina Environmental, Inc. determines percentages and type of asbestos by using EPA.approved method 600/M4-82-020-. Interim Method for the Determination of Asbestos in Bulk Samples. Bulk samples are analyzed by PLM (Polarized Light Microscopy). Asbestos is quantified by using the visual arena estimation technique and can only determine the approximate percentage of asbestos present. After a thorough search is conducted and no asbestos is detected'none detected" will be noted in the report. The essence of.polarized light imicroscopy is not to emphatically determine that no asbestos is present,merely that none was detected or, if it was, itwas I ikely to be lest.than 1.0%of the'sample. When findings reveal less than or close',to 1.0% asbestos contained in a sample, further analysis may be called for on additional samples to confirm or denounce, the initial findings. The California Code of Regulations (CCR 1529) requires bulk sampling :be conducted according to the A,H,E,R.A protocol provisions of 40 CFR Part 763.86, The A-H-E-R.A.. protocol recommends three (3) or more friable surfacing samples from a homogeneous area be collected and.analyzed before'any building material is determined to be non-asbestos containing. Scott Morrison & Associates conducts asbestos inspection surveys following the A.H.E,R.A. inspection protocol. ASBESTOS INSPECTION BY: Scott C. Morrison, DOSH BULK SAMPLES ANALYZED BY: Carolina Environmental, Inc,, NVLAP#101768-0 The results on the following page(s) indicate that asbestos Was detected in 00 of the 11 samples analyzed. SCOTTIMORRISON & ASSOCINFE'S P.O.Box 55329 31955 Date.Palm Drive, Ste.#3-5©7 Rix,geside,CA 92517 (909)624-1663 Cathedral City,CA 92234 (766)323474-33 ............. ............... .......... ........................--------- PLM0623#1101 Note:Sample Ws MC-1 thru.MC-4 were all taken from the guest house structure. Sample#MC-1 Type of material: drywall/tan Location: interior S.wall,S. room Area.:throughout interior walls Friable:no Results: none detected Sample#MC-2 Type of material:drywall/tan Locatiombatfiroom ceiling Area-Ahroughout Interior ceilings Friable-.no Results-. none detected Sample#MC-3 Type of material:exterior wall stucco/grey Locatiomexterior SW wall Area:throughout exterior walls Friable:no Results: none detected Sample#MC-4 Type of material:roofing felt/brown Location:roof above guest house Area:.throighout roof Friable-.no Results.- none detected Note:Sample Ws MC-5 thru MC-11 w i ere all taken from the adobe single-family home. Sample#MC-5 Type of materiatexterior wall plaster/grey Locatiomexterior S.-central wall Area:exterior walls Friable:no Results:none detected Sample#MG-5 Type of materialftar&gravel roofing Location:roof above house-1 st layer. AreaAhroughout roof Friable:no Results: none detected Sample XVIC-7 Type of materiatroofing felt Locatiomfoof above house-2nd layer Area.,throughout roof Friable= Results.- none detected (2) • SCOTT IvIORRISON & ASSOCIATES P-0, Box 55329 31$55 Dots Patin Drive, Ste.ft5-507 Riverside,CA 92517 (909)624-1665 Cathedral City,CA 92234 (766)3233-7743 PLM0623#1101 Sample#MC-8 Type of material:interior wall plaster/It. tan Location:interi6r wall, dining room AreaAnterior walls, dining area Friable:no Results: none detected Sample#MG-9 Type of material: final coat/white Location: interior ceiling, Kitchen Area-kitchen ceiling-1 St.layer Friable:no Results.- none det6cted Sample#MC-1 0 Type of material:drywall!white Locatiominterjor ceiling, Kitchen Area:kitchen ceiling-2nd layer FrIablemo Results: none detected Sample#MC-1 1 Type of materiabnterior wall stucco Location.-interior S.wall, kitchen Area-.interior walls, kitchen Friable:no Results: none detected Inspector Scott C.Norrison Ciartified Asbestos Consultant DOSH#92-0248 TTM 33648 expiration info Subject:TTM 33848 expiration info FroM: "Jay Wuu"<Jwuu@la-quinta.orP Dante: 2/20/2013 1:34 PM To.<david@davdmaman comp Expiration Date , =r; r3 current- tavan.!abie) Map Tentative Project#Dante Res Approval Planner Key� Map 1 Unite Date Original S8 1185 AB 333 AB 208 Tinae Ext 9 Time Ext 2 Tine Ext 3 (2-yrs, [1-y(I 12•yrs) [2-yrs] {1-yr) 11-yrl (1-yr] 17 TTM 33548 l an?an 32 6J 1712008 1;r;�,r' F;17i 0 •:i 611712013 6117.12015 M 712016? X-07/7,0F7) fd/!trr?.04 Atti;" '. aay W'uu, Associate fanner Planning DLepartaaent City of La Qui.nta . 1 of'1 6/30/2014 3:32 Phi t-ZXM2D(Q -OSI CITY OF LA QUINTA - PUBLIC WORKS DEPARTMENT GREEN SHEET PUBLIC WORKS CLEARANCE FOR RELEASE OF BUILDING PERMIT Form updated&effective 9/25/2009 1QSS �.�,� aev— -CLC--e-- Green ACGreen Sheet approvals are forwarded to the Building & Safety Department directly by Public Works. Please DO NOT submit the Green Sheet (Public Works Clearance) Packet to the Public Works Department until ALL requirements listed below are complete. Incomplete applications or applications which cannot be processed will be returned to applicant. Date: Q / 12-1�Developer: 0 �o V c Tract No.:"318 9 Tract Name. A Lot No.(s): Address(s): Q A,-vPhone Number: (e ) 400 6–L The following are the requirements for Public Works Clearance to authorize issuance of a building permit from the Building & Safety Department: ❑ CUSTOM HOMES: PROVIDE ITEMS#2,#3,#4,#5 &#7 BELOW ❑ TRACT HOMES: PROVIDE ITEMS#1,#2, #3 &#5 BELOW ❑ COMMERCIAL BUILDINGS/OTHER: PROVIDE ITEMS.#1,#2,#3, #5 &#7 BELOW ❑ WALLS, SIGNS, OTHER: PROVIDE ITEM #6 BELOW 1. Attach Pad Elevation Certificates in compliance with the approved design elevation for building pad (maximum allowable deviation of+/- 0.1 foot). Pad Elevation Certificates must be current (within 6 months of current date). If a precise grading plan creates the pad for approval, please withhold green sheet submittal until a Pad Elevation Certificate can be provided. 2. Attach geotechnical certification of grading plan compliance including compaction reports from a licensed Soils Engineer. Recently rough graded residential developments which have a previously approved geotechnical certification are exempt from this requirement. , 3. Attach recorded final map or title information/grant deed showing proposed building locations are legal lots: 4. Complete the attached <1 acre per jot or infill project Fugitive Dust Control project information form, PM10 plan & agreement or provide alternative & valid City approved PM10 plan set reference number or hard copy plan. PM10 plans for commercial & residential developments (beyond 1 lot) are submitted separately with grading plans &are subject to additional requirements. A current PM10 certification number is required. 5. Attach a copy of the rough or precise grading plan to the Public Works Department showing building location(s) for pad elevation verification. AO flood zone developments will require an approved flood plain development plan. 6. Attach supporting documentation for wall plan, monument sign, grease trap or special facility installations. 7. Complete and sign the attached water quality management plan (WQMP) exemption form, if applicable. PW approved building construction projects require either a WQMP or a completed WQMP exemption form. Approved maps/plans may be viewed at the following link: http://www.la-guinta.org/PlanCheck/m search.aspx I have reviewed and confirmed the requirements listed above as presented and find the improvements to be sufficiently complete for construction of the proposed buildings/structures/walls/signs on the subject lot(s). Pursuant to my findings, the above project may be released for building permit issuance. This section completed by City staff. q Recommended by: Date: !' /(IS—/ Public Works Distribution: ) Green Sheet to Building &Safety ( ) Green Sheet to Planning Department Declined for approval for reason(s) as follow(s), please correct and resubmit: Eudvtu SEP 12 2014 CITY OF LA QUINTA T:1Checklists- Forms&ApplicationsWorms&ApplicationslGREEN SHEET cover&PM10 less than 1 Acre Revised 10-02-12.doc COMMUNITY DEVELOPMENT 1 J City of La Quinta - PM10 Fugitive Dust Control Project Information Construction Phase PM10 Agreement <1 acre/lot or Infill Project) Project Information Project Contractor: Project Phase Project Name: (check one) I Project Tract/Lot Numbers: 3 3 LA g / N A ❑ Construction Demolition Project Street Address: 19 Ar-je-4o Je g Total Acres in Active Construction (<1 acre per 9 /2 Z/ I LA Anticipated Completion Date: 10/ Is / Lot): Anticipated Start Date: p p PM10 Contact Please note: Dust control is required 24 hours a day, 7 days a week, regardless of Information construction status. Person listed below is responsible for dust control during business and non-business hours. �~ Name: �"�,Aro. v L�OT') F Title: Company Name: M (p �,� �� � �t ce-3 Mailing Address: 6 Z cj -:axr-w ke `e ,rhe City, State,ZIP Code: 21v z(�O 6A1 9 220\ Primary Phone#: %T Fax M 24 Hour Emergency Phone#: d Coat — co -114 I Cell Phone M Email Address: Ko N ccJ" PM10 Certificate#: O - O O-O S - 9 LAZ The above stated property owner(or authorized representative): Shall act as his/her acknowledgement of dust control requirements and their enforceability, pursuant to SCAQMD Rules 403, 403.1, 401, 402, 201, 203 and PERP; :• Shall constitute an Agreement to comply with all project conditions as identified in the approved dust control plan. Acknowledges that dust control is required twenty-four (24) hours a day, seven'(7) days a week, throughout the period of project performance, regardless of project size or status; Shall ensure that each and every contractor, subcontractor and all other persons associated with the project shall be in continuous compliance with all requirements of the approved dust control plan; Shall take all necessary precautions to minimize dust, even if additional measures beyond those listed in the dust control plan are necessary; Shall authorize representatives of City/County to enter the property for inspection and/or abatement purposes; .• Shall hold harmless the City/County and its representatives from liability for any actions related to this dust control plan or any City/County initiated abatement activities.oK/6449444 9? hel ' ignature_o f roperty Owner okAuthorized Representative DatCh $puthland Title catovaW DOC a 2005-04240S7 RECORDING REQUESTED BY: 05/27/2005 08:00A Fee:43.00 Page 1 of 3 Doc T Tax Paid Re/Max Real Estate Consultants/Escrow Division Recorded in Official Records County of Riverside AND WHEN RECORDED MAIL TO: Larry W• Ward Assessor, AND MAIL TAX STATEMENT TO: County Clerk 8 Recorder�f QUINTA DEL SOL, LLC 6541 Hollywood Blvd., Suite #203 J Los Angeles, CA. 90028 Order No.65612153 M th PAGE SRP DA POOR A=OR BMF hast. Escrow No.05=04256-CB Parcel No.764-18`800-003-3 _1�M,l � "'I A R L COPY LONG REFUND NOHO EAAM T GRANT DEED "J THE UNDERSIGNED GRANTOR(S)DECLARES)THAT DOCUMENTARY TRANSFER TAX IS E1,86450 and CITY$ X computed on full value of property conveyed,or computed on full value less liens or encumbrances remaining at the time of sale. unincorporated area: OR City of Thermal and $G FOR A VALUABLE CONSIDERATION,receipt of which is hereby acknowledged, Carol Ann Scanlan, an unmarried woman hereby GRANTS to QUINTA DEL SOL, LLC the following described real property in the County of Riverside,,State of California: AS PER LEGAL DESCRIPTION HERETO DESCRIBED AS"EXHIBIT A"AND MADE A PART HEREOF. Commonly known as:81891 Avenue 58,Thermal,CA 92274 Date LPJA Carol Ann Scanlon STATE OF CALIFORNIA } 11 )S.S. COUNTY OF LDS Nl�s ) On iVlarc�. 31 .'Z= before me,the undersigned,,a Notary Public in and for said County and State, personally appeared Carol Ann Scanlon personally known to me(or proved to me on the basis of satisfactory evidence) to be the person(s)whose nameK is/are subscribed to the within instrument and acknowledged to me that hef/she/they executed the same in W/her/lWr authorized capacity(W),and that by bis/her/tbeir signature(s)on the instrument the person(g),or the entity upon behalf of which the person(PTacted,executed the instrument. WITNESS hand a official seal. Signature MELISSA KAY KESSLER -- COMM. #1479888 -{ NOTARY PUBLIC-CALIFORNIA • LOS ANGELES COUNTY My Comm.Expires Mar.30,2008 UNDER THE PROVISIONS OF GOVERNMENT CODE 23761.7. I CERTIFY UNDER THE PENALTY OF PERJURY THAT THE NOTARY SEAL ON THE DOCUMENT TO WHICH THIS STATEMENT IS AT READS AS FOLLOWS: NAME OF NOTARY:��j� � COMMISSION NUMBER: (- COUNTY WHERE BOND IS FILED: 1_0:J, STATE WHERE BOND IS FILED: CA DATE COMMISSION EXPIRES: �3teQ,bQ7� PLACE OF EXECUTION: r DATE: S .)Z6 v� SIGNATURE: .. PRINT NAME: Danny Osborn } v ORDER NO. 65612153 EXHIBIT"N' All that portion of the Northeast quarter of the Northeast quarter of Section 27, Township 6 South, Range 7 East, San Bernardino Base and Meridian, in the City of La Quinta, County of Riverside, State of California, as shown by United States Government Survey, described as follows: Beginning on a point on the North line of the Northeast quarter of said Section 517.60 feet West of the Northeast corner of said Northeast quarter of Section 27; thence at a right angle Southerly 651..00 feet; thence at a right angle Westerly 324.00 feet; thence at a right angle Northerly 651.00 feet to a Northerly line of said Northeast quarter of said Section; thence Easterly along said Northerly line 324.00 feet to the point of beginning. 4 Quinta:De!Sal LLC P.O.Box 260394 Encino , Ca 9.1426 Tuesday July 15', 2014 From : Quinta Del Sol LLC To Whom It May Concern: I Ofer Da an, member of Quinta Del Soil LLC, in regards of"the property located at 81891 58 . Av , La Quinta Ca 92253, APN 7641.80003,I authorize Guido Vitale to represent our company as necessary to .process the permitsfor demolition of existing SFR in the subject property. If you.have any questions,please don't hesitate to contact me directly at 818-266-8414. Sincerely, A"lQuinta Del Sol C. P.O.Box 260394 Encino, Ca.9.1426 i - CITY OF LA QUINTA SUB-CONTRACTOR'LIST JOB ADDRESS �� ��e� S PERMIT NUMBER OWNER e_4 t_(_C_ -BUILDER This form shall be posted on the job with_the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list musf be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance_ of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. >::::»: :>::>:;»:::::r<`>::>::>::>::»>:::z::<::>:::<:=:'<:::<:s:><:r::::>:<::::[i<:::::>:>i::: ::::::?>::'::::;:::z::::»:::..........::::<>:::>:::>:::>:>::»::::>::[:><:`:::>::<:::>::::>:<:::::<:::><:>::::::>::>::::»::>::»::;zi:>:::<:>::<:::>::::::::;::>::>`::::i:::::::>::::::<::::!>:::::::i:::r::?>:::>: is%::>'<:<:> >:i' > :::>......... e;» :::»::::<; ::.>:.>::::>:::>:> it:.>::Bus�ness:: kens ......... C................................................... :..., ....... .. ._...:.: .::..............::.:::::::::. . . . . ._::::::::::::::::::::::. ::::..::::..:::.::::::::::::::::::.::::::: Y Co.m .ens-tion.:lns.urance..::..:::::::::.. .... ;.:..:::::::.:.::::::::::.... ::.:::: ::::::::.:::::::::::.:::State.Contrac tor.s.L�cense::::::::.;::. Workers.. . Trade Clas srficatioh Contractor P11A nl U�L' G `I l � � � �t O Z 2a I � f 0 Exp.. D ate TDateL'censeNumber Company Classification License Number Exp. Carrier Name Policy Number xx xx xx)xxxx1FormatVaries1xx 44 9 C-81 (xxx xx1 xx xz xx e.9. State Fund CaIComP1 I3 S9 3,3 11 S S4e'oei I Z to SZ .... ..........;CONCET1 : ............:: : : {I 1 ' ;:. 1 I ::STRU;CT STEL( .: ::::::::::::. (. :::.::1 PL U -,'7:!. {:.:::.;;:::.: L'ATH<z<PL'ASTERz( X. C-35'.) z : .:.;:.:;.;:::.,::: . X. SfEET2`:IVIETA..::(?C !13:).<. .:..:. 5 :F:LO`Q RI .ANSU:LATION:>C2"''.>:><:> :11..::::.:::;::::. ::`PAINTING:>: L A N D`S G'A P.I N G:(:C 2 7 i O� • �� U 3 ifs' 78-495 Calle Tampico La Quinta, California 92253 OFT1 BUSINESS LICENSE DIVISION (760).777-7000 FAX (760)-777-7105 finance@la-quinta.org www.la-quinta.org To: TRI STAR CONTRACTING II INC 15501 LITTLE MORONGO ROAD ' = DESERT HOT SPRINGS CA 92240 BUSINESS LICENSE NO. 0000762 BUSINESS LICENSE RENEWAL To avoid incurring penalties (Ordinance 3.28.380), please return this invoice along with your check prior to your expiration date of: February 28,.2014. BUSINESS INFORMATION NOTICE Subject to.the provisions of the La Quinta Municipal Code Section 3.28.410, every person engaged in the business of contracting which requires a state contractor's license shall pay a business license fee either annually or semi-annually. Please mail $50 If renewing for six,months or$100 If renewing for one year. (Circle One) General-Contractor/Annual or Semi-Annual Business License Fee: $ *Surcharge for SB-1186: $ 1.00 "Penalty fee is 10% per month of total business "Penalty: % $ license fee TOTAL FEES $ Name of Owner(s) or Officer(s) and Title(s): Owned By: Corporation Partnership Individual If Corporation or Partnership: Tax I.D. #: Email Address: Vehicle License Number Permit Number (Finance Use Only) I declare under penalty of perjury•that to my knowledge, all information in this statement is true and correct. Signature(s): Title(s): Date: Thank You for doing business in the City of La Quinta *On September 19, 2012"Governor Brown signed into law SB-1186 which adds'a state fee of$1 on any'applicant for a local business license* permit, or renewal.'_ A `COPY' OF SAID POLICY OR CERTIFICATION OF CONSENT SHOWING THE AMOUNT OF COVERAGE AND EXPIRATION DATE FOR WORKER'S COMPENSATION IS REQUIRED TO PROCESS THIS APPLICATION. . Contact Information Updates or Corrections (Please print address, phone number). Business Address: Mailing Address: Phone Number: Fax Number: Please Complete Contractor's License Number: Classification: Worker's Comp. Insurance: Exp. Date: Policy Number: Authorized Persons to Sign Building Permits If you are no longer conducting business within the City, please complete the information below and return this invoice to the City. Should your business resume operations, it will be necessary to obtain a valid City Business License. I/We have ceased all business activity within the City of La Quinta effective. Business Lic.No. 0000762 *On September 19,2012 Governor Brown signed into law SB-1186 which adds-,a, state fee of$1 on any applicant for a local business license, permit, or renewal. Bin# City of La Quintd Building 8t Safety Division Permit# P.O. Box 1504, 78-495 Calle Tampico . .6.QC-AA-Zct 4 La Quints,CA 92253- (760) 777-7012. ori Building Permit Application and Tracking Sheet Project Address: 9-1 t-WeAaje. S g Owner's Name: L,(_.e, A.P.Number: LA g p0 O 3 Address: (dcJLA l Pal 1 las 0"6 d . 5i��C*ZA Legal,Description: City,ST Zip: r3,5-,G IES CA 00 Z8 Contractor: ff Telc hone: 1� — L1i N E 1 V mrf�n4tc A P � Z�O � � - Address: O 0X `3 9• Project.Description: ��-j �P.� �t�rtfl(�+-t.0 t-3 of City,ST,Zip: �� PFtLMS G4 �t22�(� ex;sd;4 vtwsis s�-fL.ic,�.iax +►•�cl�d�a6 Telephone cK9N; Ti otJ a.-01>. a'trAf.a.1•G� State Lic.#: G aq O( City Lic.#; CANt,R.Ey'E. wo4Z�. Arch.,Engr.,Designer: Address: City.,ST,Zip: 'sz?>s%A=''`,'r::...,..:,,.;.:..;.,:•,.:.::;;• ConstriTelehone: ction Type: Occupancy: State Lic.#: Project type(circle one): New Add'n Alter Repair Demo Name of Contact Person: (a V �, L� Sq.Ft: Zp p #Stories: #Units: Telephone#,of Contact Person: `Nak2 LA00- (p(7Z3 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets �/ I PIan Check submitted Item Amount Structural Calcs. Reviewed,ready for corrections Plan Clieck Deposit Truss Calcs. Called Contact Person Plan Check Balance• Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2od Review,ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. H.O.A.Approval Plans resubmitted Grading IN IiOUSE:- 7rd Review,ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub.Wks.Appr Date of permit issue Scliodl Fees Total Permit Fees